Declining MoCA Score

Terri 2.0

My DH was diagnosed with MCI in April. In July, after all the tests including an MRI, I was told he has ALZ and VD mixed.

In July his MoCa score was 28; yesterday it was 19. This seems like an awfully fast progression to me; is it? I see so many changes constantly. I would say that executive functioning has seriously declined, and his short term memory is pretty much gone. Thankfully his anger and anxiety have almost disappeared with the sertraline.

Now his Memory Doctor is still ramping up his sertraline, and she said that when he finishes his Chantix for smoking cessation (it worked!) the end of October she's going to start him on Aricept.

Have any of you experienced a drop in scores so quickly? 2.5 months for that steep of a decline seems too fast.

Thanks in advance for your help.

Jgirl57

I am glad you are seeing good results with the sertraline. To be honest, the first couple of MoCA tests my HWD had, I really think they “gave” him a few points. Now that his decline is more obvious to the doctors , they did not give him any assist and scored him more accurately . He now scores 16. From what I have learned here, progression really varies. Aricept may help with his daily functioning but it doesn’t stop progression .

Pat6177

I found that the tests varied depending on who gave the test. PCP definitely “gave” him some points. Dementia center is more structured with the testing.

Belle

Agree with the previous comments on how a doctor administers and scores the test can impact the results. That being said, I have read that VD shows up as declines in a stairstep manner unlike ALZ which shows up as a more steady downward decrease in abilities (I am generalizing a bit). My DH has neurocognitive disorder caused by an autoimmune disease and he has had a stairstep progression. My DH will have a long period with no decreases in his abilities and then bam! I notice a huge change. Also I find that how tired my DH is at an appointment affects his testing and ability to communicate.

Terri 2.0

The July and September tests were both done at the Dementia Center, both scored by his dementia geriatrician. She seemed a little surprised, but said that his next test in December would tell the story. The only difference was the time of day; 1st test was in the am, 2nd mid afternoon.

But - I discovered yesterday that he had been taking my anxiety med. I was filling my weekly pill keeper, and last week I had an almost full 90 day supply pill bottle. Yesterday it was almost empty. I don't take them every day, just as needed, but I'm prescribed 4 per day. I asked him if he knew what happened to them, and he said he'd taken them. I told him to take his meds, not mine, and I took the bottle away. They are non-narcotic, but that's a lot of pills he took in a week. That might partly explain why he seems like he's half out of it lately.

He flat refuses to let me handle his meds. I want to handle all the meds and keep them secure except for the weekly pill keepers. He decided to increase his sertraline, and I let his dr. know as soon as I realized, and she said that was ok but that I need to find a way to handle all the meds.

Any suggestions on how to do that without starting an ugly argument?

harshedbuzz

@Terri WNC

I would have the pharmacy do pill packs for you both; tell DH they are "doctor's orders" or "how they do this now". Lock them all away taking one pack out for each of you in the AM. I would avoid discussing or explaining the real reason why.